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2.
Arch Dis Child ; 97(11): 982-4, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22863689

RESUMEN

PURPOSE: The Cystic Fibrosis Trust in 2007 published a recommended target of 75-150 nmol/L for 25-hydroxyvitamin D (25-OHD). In 2008 we found that only 10% of pancreatic insufficient (PI) children met this target. An increase in supplementation was implemented and a repeat audit performed in 2010. METHODS: PI children ≥1 year under sole-care in our regional centre were included. Vitamin D3 supplementation increased by >450% to either 3800 IU/day liquid or 800 IU daily plus 20,000 IU weekly tablets. In 2010 pancreatic sufficient (PS) children were also audited separately. RESULTS: The median 25-OHD level increased from 51.5 nmol/L in 2008 (n=78, 10% >75 nmol/L) to 72 nmol/L in 2010 (n=72, 51% >75 nmol/L), p<0.0001. In PS children (n=15 in 2010) 87% had 25-OHD levels <75 nmol/L. CONCLUSIONS: A substantial increase in supplementation led to a significant increase in 25-OHD levels but around half still failed to reach the recommended target.


Asunto(s)
Calcifediol/sangre , Fibrosis Quística/sangre , Insuficiencia Pancreática Exocrina/tratamiento farmacológico , Deficiencia de Vitamina D/tratamiento farmacológico , Adolescente , Calcifediol/uso terapéutico , Niño , Preescolar , Fibrosis Quística/complicaciones , Fibrosis Quística/fisiopatología , Suplementos Dietéticos , Insuficiencia Pancreática Exocrina/etiología , Humanos , Lactante , Auditoría Médica , Deficiencia de Vitamina D/etiología
3.
ANZ J Surg ; 78(1-2): 34-41, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18199203

RESUMEN

BACKGROUND: Quality of life (QOL) and nutritional assessment of patients with head and neck cancer can provide additional information about the effects of treatment beyond the standard measures of disease control and survival. Integrating a prospective evaluation program into a multidisciplinary service may ensure that a more holistic model of care is developed. METHODS: Prospective evaluation of QOL and nutrition before and after treatment for head and neck cancer was implemented in 2001. All patients enrolled in the program were treated with curative intent. Patients completed the European Organisation for Research and Treatment of Cancer Core QOL Questionnaire and Head and Neck Specific Module before treatment and at 3, 6 and 12 months after completion of therapy. In conjunction, patients underwent nutritional assessment by body mass index, biochemical parameters and the patient-generated subjective global assessment tool. RESULTS: Among 288 patients who consented to participate in this study, 134 patients completed the QOL assessment criteria and were eligible for evaluation. Examples of QOL and nutritional data for patients with cancers of the oral cavity, oropharynx, nasopharynx, larynx, hypopharynx, parotid gland and paranasal sinus, and also unknown primary cancers are given. Implementation of this prospective assessment program required appropriate resources and was hampered by time constraints, logistics with blood tests and patient compliance. CONCLUSIONS: Despite difficulties with implementation, the information concerning QOL and nutritional status obtained in this study provided an appreciation of the long-term functional effects of treatment for head and neck cancer. Prospective QOL assessment and nutritional evaluation should become integral components of the care of patients with cancers of the head and neck.


Asunto(s)
Atención Integral de Salud/organización & administración , Neoplasias de Cabeza y Cuello/terapia , Evaluación Nutricional , Evaluación de Resultado en la Atención de Salud/métodos , Calidad de Vida , Índice de Masa Corporal , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/psicología , Humanos , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Encuestas y Cuestionarios
4.
Arch Otolaryngol Head Neck Surg ; 133(6): 533-40, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17576902

RESUMEN

OBJECTIVE: To prospectively assess quality of life in patients undergoing chemoradiation therapy for nasopharyngeal cancer. Concurrent chemoradiotherapy is standard for advanced nasopharyngeal cancer; however, the toxic effects of this treatment are substantial. DESIGN: Prospective evaluation of quality of life and nutritional status before and after treatment for nasopharyngeal carcinoma. PATIENTS AND INTERVENTION: A cohort of 14 patients, treated with concurrent chemoradiotherapy for 7 weeks, completed the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire and Head and Neck Module before and 3, 6, 12, and 24 months after treatment. Changes in score were analyzed and correlated with the toxic effect grade. RESULTS: Quality of life issues during the 24 months of follow-up included poorer global health (P = .01), fatigue (P = .01), appetite loss (P<.001), swallowing difficulties (P = .002), sense problems (P = .03), difficulty with social eating (P = .005), dental problems (P = .045), trismus (P = .001), xerostomia (P<.001), sticky saliva (P = .001), cough (P = .02), and feeling ill (P = .03). Pain (P = .004) and emotional functioning (P<.001) significantly improved from the pretreatment rating. The median weight loss was 7 kg, with most weight loss occurring during treatment, despite nutritional support with gastrostomy feeding tubes. One patient still required percutaneous endoscopic gastrostomy feeding at 2 years after treatment. Physician-scored toxic effects correlated poorly with quality-of-life scores. CONCLUSIONS: Quality of life and functional assessment should be important end points in the follow-up of patients with nasopharyngeal cancer who receive chemoradiotherapy. This study supports the need for ongoing support and rehabilitation in a multidisciplinary setting.


Asunto(s)
Carcinoma/terapia , Neoplasias Nasofaríngeas/terapia , Estado Nutricional/fisiología , Calidad de Vida , Adulto , Anciano , Carcinoma/psicología , Quimioterapia Adyuvante , Estudios de Cohortes , Tos/etiología , Trastornos de Deglución/etiología , Emociones , Nutrición Enteral , Fatiga/etiología , Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Estudios de Seguimiento , Gastrostomía , Humanos , Persona de Mediana Edad , Neoplasias Nasofaríngeas/psicología , Terapia Neoadyuvante , Estudios Prospectivos , Radioterapia Ayuvante , Saliva/fisiología , Trastornos de la Sensación/etiología , Enfermedades Dentales/etiología , Trismo/etiología , Pérdida de Peso , Xerostomía/etiología
5.
Eur J Paediatr Neurol ; 11(4): 240-2, 2007 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17287135

RESUMEN

A 15-week old male infant presented with bilateral lower motor neuron facial palsy of unknown cause. Subsequently his growth deteriorated and he developed progressively worsening cough and wheeze. A diagnosis of cystic fibrosis was confirmed and hypovitaminosis A detected. Improvement of the facial palsy was noted following standard management of cystic fibrosis including vitamin A supplementation.


Asunto(s)
Fibrosis Quística/complicaciones , Fibrosis Quística/fisiopatología , Parálisis Facial/etiología , Suplementos Dietéticos , Humanos , Lactante , Masculino , Vitamina A/uso terapéutico , Deficiencia de Vitamina A/complicaciones
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